• Title/Summary/Keyword: Thrombus

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Surgical Management of Aortic Insufficiency in Behcet`s Syndrome - An Experience of 8 Cases - (Behcet 씨 증후군에 의한 대동맥판 폐쇄부전의 수술치험 -3례 보고-)

  • 원용순
    • Journal of Chest Surgery
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    • v.21 no.5
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    • pp.899-904
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    • 1988
  • In Behcet syndrome, cardiac involvements are rare and have been reported pericarditis, myocarditis, right heart endocardial fibrosis, right ventricle mural thrombus with pulmonary embolism, active endocarditis, granulomatous endocarditis, conduction disturbance, acute aortic insufficiency, mitral valve prolapse. Our three patients underwent AVR because of aortic insufficiency and ascending aorta enlargement combined with Behcet syndrome. Two patients had mitral regurgitation too. So one underwent MAP and the other underwent MVR concomitantly. One who underwent AVR have been well for 50 months. Another who underwent AVR+MAP and redo AVR due to aortic paravalvular leakage was died of congestive heart failure. The other who underwent AVR+MVR and repeated AVR three times because of aortic paravalvular leakage is in condition of aortic paravalvular leakage. Paravalvular leakage is considered to recur due to progressive dilatation and fragility of aortic root that is the result of pathologic change of Behcet syndrome in it. If Open heart surgery is needed in Behcet`s syndrome during inflammatory reaction is active, postoperative complications such as paravalvular leakage or suture line rupture may be prevented with pre- and postoperative anti-inflammatory management.

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Mitral Valve Replacement: Report of Two Cases (승모판막 이식수술: 2례 보고)

  • 장순명
    • Journal of Chest Surgery
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    • v.6 no.2
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    • pp.195-202
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    • 1973
  • Two patients were admitted with chief complaints of exertional dyspnea and palpitation respectively. Physical examination showed Grade III and Grade II to III systolic rumbling murmur at apex in each case. Chest X-ray and EKG findings were compatible with mitral insufficiency in both cases. The diseased valves were replaced with Beall mitral valve prosthesis under cardiopulmonary bypass using hemodilution technic. The first patient died of asphyxia due to tracheomalacia complicated after tracheostomy 3 months after operation and the 2nd patient was discharged in good condition one month after operation-Autopsy of the 1st patient showed no thrombus formation, no disc variance, and good epithelization of valve cuffs. In the second case clinical improvement was remarkable with decreased heart size.

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A Clinical Study for Pre- and Intraoperative Risk Factors of Hospital Mortality after Mitral Valve Replacement (승모판막 치환술후 조기사망의 술전 및 술중 위험인자에 대한 임상적 고찰)

  • 박승규
    • Journal of Chest Surgery
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    • v.23 no.2
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    • pp.236-244
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    • 1990
  • To improve the prognosis of mitral valve replacement surgery, analysis and evaluation of pre and intra operative risk factors will be very much valuable. Author studied 205 cases of mitral valve replacement from Feb 1982 to June 1989 for the risk factors of hospital death. 90 patients were male and 115 were female, and age was from 16 to 59 years, Mitral stenosis dominant lesions were 91 cases and regurgitation 114. Suspected risk factors were NYHA functional class, cardiothoracic ratio, implanted valve type and size, operation time, age and sex, thrombus in left atrium, atrial fibrillation, aortic cross clamping time, left ventricular end diastolic and systolic dimension, nephropathy, hepatopathy and respiratory insufficiency. Statistic analysis was performed by X2 test between survivors and death group. Statistical significances as pre and intraoperative risk factors of hospital death after mitral valve replacement were confirmed in those presence of AF on the EKG, NYHA functional class[>IV], cardiothoracic ratio[>70%], and implanted valve size[>33mm]

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A case study of patient with Ischemic Cerebrovascular Accident at Puerperium (산욕기에 발생한 뇌경색증 1예의 임상 보고)

  • Jung, Ho-Joon;Chang, Young-Chul;Kwon, Do-Ick;Ahn, Jong-Pil
    • The Journal of Internal Korean Medicine
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    • v.21 no.5
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    • pp.883-887
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    • 2000
  • A clinical study was carried out 1 case of ischemic cerebrovascular accident which occurred at puerperium in a 27 year-old woman followed by vaginal delivery The results were as follows: 1. In the clinical view, it was thought that the cause of this case is intracranial venous thrombus, because the symptom-headache, foaming at the mouse, acromyotonia, hemiparesis- occurred in the postpartum and functional outcome is good. 2. In this case, the patient's functional system of spleen-stomach is usually weak, and due to delivery the functional system of spleen-stomach is more insufficient. so it can not control damp-phlegm(濕痰). In addition, vital energy of liver stagnate.

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A Case of the Giant Aneurysm in the Distal Portion of the Posterior Cerebral Artery - A Case Report - (후대뇌동맥 원위부에 발생한 거대동맥류 1례 - 증례보고 -)

  • Kim, Jae-Yeoup;Choi, Ha-Young
    • Journal of Korean Neurosurgical Society
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    • v.29 no.7
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    • pp.963-967
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    • 2000
  • The aneurysm arising from the posterior cerebral artery is relatively uncommon, and has been reported in 0.7- 2.2% of whole cerebral aneurysm. Moreover, only a few cases of the giant aneurysm over 2.5cm in diameter arising from the distal portion of the posterior cerebral artery have been reported. Neurologic complications may occur after surgical treatment of this aneurysm due to difficult surgical approach and neurovascular complexity around the brain stem. Authors experienced a case of the thrombosed giant aneurysm with approximately 2.7cm in diameter arising from the P2 segment of the left posterior cerebral artery. Complete removal of the thrombus in the aneurysmal sac and direct neck clipping was performed via left subtemporal approach.

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Thrombosis of Left Common Iliac Artery Following Anterior Lumbar Interbody Fusion : Case Report and Review of Literatures

  • Kim, Jin-Sung;Choi, Kyung-Chul;Jung, Byung-Joo;Lee, Sang-Ho
    • Journal of Korean Neurosurgical Society
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    • v.45 no.4
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    • pp.249-252
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    • 2009
  • We report on a case of thrombosis of the left common iliac artery following anterior lumbar interbody fusion (ALIF) of L4-5 in a 79-year-old man with no previous medical problems, including peripheral vascular disease. After completing the ALIF procedure, the surgeon could not feel the pulsation of the left dorsalis pedis artery, and the oxygen saturation ($SaO_2$) had fallen below 90% from pulse oxymetry on the left great toe. Thrombectomy was successfully performed after confirming the thrombus in the left common iliac artery using Computed Tomography (CT) angiography. Thrombosis of the common iliac artery is very rare following ALIF. However, delayed diagnosis can lead to disastrous outcome. Although elderly patients have no cardio-vascular disease or vessel calcification in pre-op evaluation, the possibility of a complication involving L4-5 should be considered.

Numerical analysis of the 3D fluid-structure interaction in the sac of artificial heart (인공심장 sac내의 3차원 유체-구조물 상호작용에 대한 수치적 연구)

  • Park M. S.;Shim E. B.;Ko H. J.;Park C. Y.;Min B. G.
    • 한국전산유체공학회:학술대회논문집
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    • 2000.05a
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    • pp.27-32
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    • 2000
  • In this study, the three-dimensional blood flow within the sac of KTAH(Korean artificial heart) is simulated using fluid-structure interaction model. The numerical method employed in this study is the finite element commercial package ADINA. The thrombus formation is one of the most critical problems in KTAH. High fluid shear stress or stagnated flow are believed to be the main causes of these disastrous phenomenon. We solved the fluid-structure interaction between the 3D blood flow in the sac and the surrounding sac material. The sac material is assumed as linear elastic material and the blood as incompressible viscous fluid. Numerical solutions show that high shear stress region and stagnated flow are found near the upper part of the sac and near the comer of the outlet during diastole stage.

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Surgical Treatment of Intrahepatic Inferior Vena Cava Obstruction: Three Cases Report (간내 하공정맥 폐쇄증: 수술 3례 보고)

  • 김자억
    • Journal of Chest Surgery
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    • v.11 no.2
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    • pp.161-164
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    • 1978
  • We operated three cases of intrahepatic inferior vena caval obstruction from January, 1969 to February, 1978 at the department of Thoracic and Cardiovascular Surgery in Seoul National University Hospital. They were all female. And their ages were 33, 38 and 32 respectively. The lesions were the same site; just above the opening of the hepatic vein of inferior vena cava. In first case, segmental narrowing of the inferior vena cava without thrombosis was noted. In second case; thrombus occluded the inferior vena cava and left hepatic vein. In third case, we observed membrane of 4mm thickness which occluded the lumen completely. They were totally operated by using cardiopulmonary bypass. Their post-operative courses were good in the last two cases and re-obstruction was suspected in the first case.

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Surgical Retrieval of Fractured Percutaneous Coronary Intervention Guidewire (경피적 관상동맥 중재술 시 골절된 가이드 와이어의 외과적 제거)

  • Lee Jun-Wan;Kim Sang-Pil
    • Journal of Chest Surgery
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    • v.39 no.8 s.265
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    • pp.640-642
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    • 2006
  • Entrapment and fracture of coronary angioplasty hardware are rare complications of percutaneous coronary intervention (PCI). Retained guidewire should be removed either percutaneously or surgically, because it could serve as a nidus for thrombus formation. We report on a successful surgical retrieval of entrapped PCI guidewire and subsequent bypass grafting of the affected coronary vessel.

Cloning, Expression, and Renaturation Studies of Reteplase

  • Zhao, Youchun;Ge, Wang;Kong, Young;Zhang, Changkai
    • Journal of Microbiology and Biotechnology
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    • v.13 no.6
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    • pp.989-992
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    • 2003
  • Recombinant human tissue plasminogen activator deletion mutein (Reteplase) is a clinically promising thrombolytic drug. Reteplase cDNA was subcloned into a bacteria expression system, and the resultant recombinant was biologically characterized. The Reteplase was expressed in Escherichia coli as an inclusion body, and the downstream processes of the Reteplase inclusion body included denaturation, renaturation, and purification. A protein disulfide isomerase (PDI) was used to assist the refolding of Reteplase, and it was found to increase the refolding rate from less than 2% to more than 20%. The refolded Reteplase was purified through two chromatography steps, including lysine-coupled agarose affinity chromatography and then CM-sepharose cation-exchange chomatography. The purity of r-PA was analyzed by Western bolt analysis, and N-terminal amino acid and amino acid composition analyses confirmed the end-product. Reteplase showed higher thrombolytic potency in an animal thrombus model.